Repair Café Wairarapa Booking Form
Please complete one form per item
Repair Café Wairarapa booking date
*
Saturday, September 6th, Masterton
other
1. Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
2. Item for Repair. Please include as many details as possible: What item you would like repaired? (e.g., toaster, jacket, bicycle, laptop, chair). What is the brand/model (if applicable)? What is the approximate age of item? What materials (if known)?
*
Would you like to include a photo of your item?
3. Issue or Fault (Briefly describe what’s wrong with the item).
*
4. Has it been repaired before?
*
yes
no
If yes, please describe:
5. Replacement Parts. Do you think the repair will require a part to be replaced?
*
yes
no
If yes, do you already have the replacement part?
*
yes
no
unsure
6. Category of Repair (tick all that apply)
*
Please Select
Clothing/Textile Repair (sewing, mending, darning)
Electronics/Small Appliances
Furniture/Woodwork
Bicycle/Skateboard
Knife/Tool Sharpening
Jewelry Repair
Toy Repair
Plant care and diagnosis
Other
If other, please describe
7. Special Notes. Please note any safety concerns, hazardous materials, or accessibility requirements.
*
8. Do you need assistance on the day of the event? (e.g., language or accessibility support). Please explain.
Submit
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